3%) because of multiple lymph node metastases or margin involvement. With a median follow-up time of 73&nbsp;mo, local recurrence was found in 3.3%, distant metastases in 2.5%, and contralateral breast cancer in 3.7%. All patients with local recurrence did not receive radiation therapy as adjuvant treatment. CONCLUSIONS Among the patients who underwent immediate one-stage autologous reconstruction after breast surgery, 3.3% had local recurrence. For patients with margin involvement, radiation therapy is a promising option. BACKGROUND Surgical resection is a mainstay of colorectal cancer treatment, and prior studies have shown improved outcomes in patients undergoing surgery for colorectal cancer by colorectal surgical specialists compared with nonspecialized surgeons. Here, we examine the geographic distribution of colorectal surgeons in the United States and its relationship with sociodemographic characteristics of the served population. METHODS The Area Health Resource File from 2017 to 2018 was used to identify the number and location of colorectal surgeons practicing throughout the United States and sociodemographic characteristics at the county and hospital referral region (HRR) level. The main outcomes of interest were the density of colorectal surgeons per 100,000 population and associations with sociodemographic characteristics at the county and HRR level based on multivariable linear regression. RESULTS In multivariable analysis, regions with higher proportion of nonwhite individuals and college-educated individuals had significantly more colorectal surgeons per 100,000 population, whereas regions with higher proportions of uninsured individuals had significantly fewer colorectal surgeons per 100,000 population at both the county and HRR levels. CONCLUSIONS Geographic and sociodemographic variability exists in the distribution of colorectal surgeons in the United States. Such variability may be contributing to disparities in access to specialized colorectal care. BACKGROUND Acute pancreatitis (AP) is a common gastrointestinal disorder with a high mortality rate. This study evaluated the incidence of and risk factors for reoperation after debridement of AP. METHODS This retrospective study included 168 patients diagnosed with AP who had undergone debridement between January 2007 and December 2017 at our hospital. https://www.selleckchem.com/products/gdc-1971.html Patients were divided into single-operation and reoperation groups separately. RESULTS Sixty-eight (40.24%) patients underwent reoperation after AP debridement. The main procedure for reoperation was debridement of necrosis. In univariate analysis, the risk factors for reoperation included younger age; higher admission temperature and heart rate; higher levels of C-reactive protein (CRP), blood urea nitrogen and creatinine; higher Acute Physiology and Chronic Health Evaluation II score and rate of continuous renal replacement therapy; shorter operation interval; lower postoperative albumin level; and high incidence of preoperative and postoperative complications. Multivariate logistic analysis indicated that independent risk factors for reoperation included higher levels of C-reactive protein and creatinine in admission, preoperative percutaneous catheter drainage, and postoperative complications. CONCLUSIONS The general characteristics and clinical procedures of patients with AP after debridement might affect prognosis and reoperation. The identification of risk factors could help clinicians to provide specific treatment, better ward management, and stratification of reoperation risk. BACKGROUND The Chris Hani Baragwanath Academic Hospital (CHBAH) Adult Burns Unit (ABU) often operates in excess of its capacity. Our aim was to investigate the risk factor profile of the ABU population and to apply the Baux score as a model for predicting mortality to assist with appropriate resource allocation. METHODS In this retrospective study, the Baux score was calibrated to the mortality rates in ABU burn population and the effects of various variables on mortality were assessed with Mann-Whitney U-test, chi-square test, and regression analysis. RESULTS The relationship between the Baux score and mortality rate was characterized by this regression equation y&nbsp;=&nbsp;-0.0002×3 + 0.0547×2 - 2.5815× + 32.649, which was used to tabulate expected mortalities per Baux score band. Univariable regression analysis revealed that Baux score, gender, suspected inhalation injury, mechanism, and intent each had statistically significant associations with mortality (P-values less then 0.05), whereas the multivariable model showed that only Baux score, gender, and suspected inhalation injury were statistically significant factors in predicting mortality. CONCLUSIONS An increase in the Baux score is the most predictive and statistically significant risk factor and is easy to calculate. Thus, expected mortality can be determined using the Baux score band versus mortality table created in this study to assist with prioritizing patients in a resource-limited environment. BACKGROUND Long-gap esophageal atresia (LGEA) precludes immediate primary repair. When delayed primary esophagoesophagostomy (DPE) is not feasible, a reverse gastric tube (RGT) is a potential salvage option. The purpose of this study was to determine if DPE and RGT had both similar short-term and long-term outcomes. METHODS A retrospective review of all EA patients from 1994 to 2016 was undertaken. Data were stratified by surgical management (DPE versus RGT). Baseline demographics, operative information, postoperative management, and complications were analyzed. Descriptive statistics were used and P-values less then 0.05 were considered statistically significant. RESULTS Two hundred and eighteen patients with EA were treated during this period; 37/218 (17%) had LGEA. Mean gap length was 3.3&nbsp;±&nbsp;1.2&nbsp;cm. Thirty-three patients underwent some form of repair, all of which were managed initially with a gastrostomy tube feeds. Twenty-five patients underwent DPE with 89% of these never requiring revision, and 86% having excellent function with long-term follow-up. In eight patients, esophageal length was never adequate for DPE; therefore, six were reconstructed with RGT, and two underwent gastric transposition. There were no significant differences in complications, revisions, ventilator days, overall length of stay, weight percentiles, or conduit function between children undergoing RGT compared with DPE at a mean follow-up of 5.5&nbsp;years. CONCLUSIONS Surgical treatment of LGEA is complex, and controversy exists regarding the optimal repair method when DPE is not feasible. In this series, DPE after gastrostomy tube feeds often allowed for sufficient esophageal lengthening with satisfactory long-term esophageal function. However, when adequate length for DPE was not attainable, these data suggest that RGT is a viable conduit with favorable postoperative outcomes.